Questions and Answers

S.J from Fort Smith, AR writes... Hello, I am 48 years old and have recently been diagnosed with osteoarthritis in my right thumb joint. I have experienced pain in the joint for at least one year. The pain finally became constant without ever easing forcing me to see an orthopedic hand specialist. I was informed by the specialist that I waited too long and the majority of the cartilage in the joint was destroyed. The options he gave were: 1) fusion, to fuse the thumb in a fixed position, or 2) tendon reconstruction of the joint, adding soft tissue to repair the destroyed cartilage. Which leads to my question, are there other options such as an implant, if so, is there a reasonable success rate? The specialist injected the joint with cortisone which has assisted in easing the severe pain, about 10 days ago, however in the past day or so I have developed an occasional sharp and shooting pain on the inside (left) of the wrist joint similar to what I was experiencing in the thumb. This is a new experience for me and I am searching for suggestions and options.

Thanks for your time.

Dear S.J,
Your dx is very common especially with individuals who use there hands very actively during the day.
In my experience, I have not seen many of the thumb joint replacements over the last several years. They were very popular 10 years ago however many of the people who had them presented with fractured, dislocated, and infected implants that eventually had to be removed.

What is most commonly being done is the soft tissue interpositional arthroplasty that you described in your message. A graft of a tendon is used as a spacer with the arthritic bone being removed. Many surgeons do it slightly differently depending upon the amount of damage there is to the joint. From my experience this has been a great surgery providing the patient significant relief. Some Physicians will fuse the middle joint of the thumb in addition if the joint is also severely damaged and unstable.

I recommend you get several opinions and make sure you are comfortable with your options. You have some excellent Hand Surgeons and Therapists in Texas.
I hope that was helpful!

 

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